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Supplementation of micronutrients in children and food fortification initiatives in Sri Lanka: benefits versus risks
Author(s) -
Jayatissa Renuka,
Fernando Dulitha N.
Publication year - 2019
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.13987
Subject(s) - micronutrient , environmental health , medicine , iodised salt , fortification , iodine deficiency , food fortification , malnutrition , vitamin , micronutrient deficiency , anemia , public health , toxicology , population , food science , biology , nursing , thyroid , pathology
In recent decades, Sri Lanka has made substantial progress in reducing the burden of micronutrient deficiencies in children by the provision of vitamin A megadose and micronutrient supplementation programs for children of 6–23 months, along with universal iodization of salt. Consumption of voluntarily fortified foods by children was also considerably increased. The objective of our study here was to review such interventions, which are beneficial in childhood, and to assess the risk of toxicity due to excessive intakes of iron, vitamin A, and iodine. Our analysis was performed using data from two national micronutrient surveys, market surveys, and key informant interviews. Data on coverage, usage, and nutrient content of certain foods were compiled to gauge consumption of iron, vitamin A, and iodine among children. We found that the severity of anemia and vitamin A and iodine deficiencies declined from moderate‐to‐severe and that supplementation and fortification can lead to an excess of vitamin A that may cause toxicity, while iron and iodine deficiency appears to be no longer a public health concern in Sri Lanka. We recommend review and scaling back of national supplementation programs and monitoring of fortification initiatives to prevent micronutrient toxicity in the future.